Friendship Manor - Rock Island Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
146099
Provider Name
FRIENDSHIP MANOR
Provider Address
1209 21ST AVENUE
ROCK ISLAND, IL 61201
ROCK ISLAND, IL 61201
Provider Phone Number
(309) 786-9667
Provider SSA County
890
Provider County Name
Rock Island
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
89
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRIENDSHIP MANOR INC
Date First Approved to Provide Medicare and Medicaid services
2005-12-09
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.10506
Reported LPN Staffing Hours per Resident per Day
0.92532
Reported RN Staffing Hours per Resident per Day
0.74810
Reported Licensed Staffing Hours per Resident per Day
1.67342
Reported Total Nurse Staffing Hours per Resident per Day
4.77848
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08861
Expected CNA Staffing Hours per Resident per Day
2.45297
Expected LPN Staffing Hours per Resident per Day
0.58411
Expected RN Staffing Hours per Resident per Day
0.88378
Expected Total Nurse Staffing Hours per Resident per Day
3.92086
Adjusted CNA Staffing Hours per Resident per Day
3.10598
Adjusted LPN Staffing Hours per Resident per Day
1.31484
Adjusted RN Staffing Hours per Resident per Day
0.63249
Adjusted Total Nurse Staffing Hours per Resident per Day
4.91259
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-30
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-07-11
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
10.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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